Changing role of surgery in the treatment of pulmonary tuberculosis.

Abstract

During the past two decades, profound changes have occurred in the role of surgical therapy in the treatment of pulmonary tuberculosis. The changes have evolved mainly as the result of the introduction of effective antituberculous chemotherapy. Streptomycin sulfate (1944), para-amino salicylic acid (1946), and isoniazid (1952) became, and continue to be, the first line drugs. Numerous second line drugs (viomycin sulfate, cycloserine, pyrazinamide, ethionamide sulfate, and others) have been introduced and are of benefit in special situations. With the development of appropriate drug regimens, the types of surgical procedures performed have changed from almost exclusively collapse therapy to practically all resections. Accompanying the evolution of this development, the indications for, as well as the frequency of, surgical intervention in patients with pulmonary tuberculosis have changed. The experience of the Surgical Department of the Chicago Municipal Tuberculosis Sanitarium may be utilized to illustrate this changing pattern over the course of the